Wednesday, October 13, 1999 Published at 16:21 GMT 17:21 UKHealthMilburn: Reforms will proceedAlan Milburn: "Defeat the forces of conservatism in the NHS"In his first public appearance as Health Secretary, Alan Milburn has warned doctors that he will push through the government's "radical" NHS reforms.

Mr Milburn signalled on the BBC's Today programme that he had no intention of letting up the pressure.

"There will always be forces of conservatism in the NHS and elsewhere but there is a modernising, radical agenda for the NHS which I am determined to pursue because quite simply the NHS can't afford to stand still," he said.

"Those who say the pace of change in the NHS is already too fast misunderstand both the mood of patients and staff."

Mr Milburn said expectations had changed since the NHS was formed in 1948.

"People shop at all times of day and night, they buy their insurance over the phone and, frankly, they expect a modern National Health Service to be equally fast and convenient."

But doctors have argued that to compare medical care to convenience shopping is nonsensical, and little more than a publicity stunt.

'Not enough testing'

During its annual conference, the British Medical Association attacked the pace of change but was accused of being backwards looking by the government.

Dr Ian Bogle, chairman of BMA Council, said: "Although I understand where the Government is trying to get to with its reforms, I am yet to be convinced that at the speed it is going and without evaluation this is money wisely invested.

"I am not totally convinced by the argument that in the days of convenient shopping and convenient banking the health service is able to or should deliver a 24-hour routine service."

Dr Bogle said doctors were not opposed to change.

Dr Ian Bogle: 'doctors do not oppose change'

"We have demonstrated over the last 10 years that we are able to cope with a rapidly changing health care agenda and protect the care of patients.

"But we need to know what the Government is planning in advance of announcements to give us an opportunity to respond in a constructive way._

The BMA did welcome Mr Milburn's intention to increase the number of doctors and nurses in the service.

The health secretary also said he wanted to relieve the pressure on GPs by increasing use of the telephone helpline NHS Direct.

Praise for predecessor

"Frank Dobson has done a quite brilliant job in laying the foundations for a modern NHS but now is the time to build on those foundations by upping the pace of change," he said.

"By the time we have finished our 10-year programme of modernisation the National Health Service of 1948 will be unrecognisable. It will remain true to its values but they will be delivered in new and modern ways."

He was asked if he regretted Labour's pledge to bring down waiting lists because it was a "plain daft" measure of whether the NHS was working.

He replied: "I tell you who doesn't think it is plain daft - the 500,000 extra patients who were treated last year.

"This war on waiting is going to continue and indeed is going to be intensified because what patients and staff want is a fast convenient, modern National Health Service."

"The NHS is in crisis. Yet all Alan Milburn can do is accuse our doctors of being the obstacle to progress in the NHS.

"How dare he? But for the dedicated professionals working throughout the NHS, the system would have collapsed by now."

Mr Milburn visited the Chartwell Cancer Unit at Farnborough Hospital in Bromley, on Wednesday where he called for an end to demarcation between "health and social care, primary and secondary care and between clinical professionals
too".